Significant predictors of overall survival in patients with hepatocellular carcinoma after surgical resection

Chih Wen Lin*, Yaw Sen Chen, Chih Che Lin, Po Huang Lee, Gin Ho Lo, Chia Chang Hsu, Pei Min Hsieh, Kah Wee Koh, Ming Jong Bair, Chia Yen Dai, Jee Fu Huang, Wan Long Chuang, Yao Li Chen, Ming Lung Yu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

20 Scopus citations

Abstract

Background The predictive factors of overall survival after hepatectomy for HCC remain controversial and need to be investigated. Methods In total, 535 consecutive HCC patients undergoing resection were included and their clinicopathological data and overall survival were recorded. Both the tumor and adjacent non-tumor (ANT) tissues were subjected to immunohistochemistry analysis for the expression of autophagy-related markers. Results Death was observed for 219 patients, and the cumulative overall survival rates at 1, 3, 5 and 7 years were 91.0%, 72.3%, 58.8%, and 27.7%, respectively. In the multivariate analysis, mortality was significantly associated with the following: diminished LC3 expression in both the tumor and ANT tissues, in the HCC tissues alone and in the ANT tissues alone (hazard ratio/95% confidence interval: 6.74/2.052–22.19, 6.70/1.321–33.98 and 2.58/1.499–4.915, respectively); recurrent HCC (5.11/3.136–8.342); HBV infection (2.75/1.574–4.784); cirrhosis (1.78/1.059–2.974); and antiviral therapy (0.42/0.250–0.697). The 5-year overall survival rates were 70.2%, 57.3%, 49.6% and 10.7% for patients with positive LC3 expression in both tissue types, in the HCC tissues alone, in the ANT tissues alone, and in neither tissue type, respectively. The 5-year overall survival rates were 56.7%, 47.3%, 51.2% and 38.7% for patients with HBV-related HCC, cirrhosis, no antiviral therapy, and recurrent HCC, respectively, and these rates were significantly lower than those in their counterparts. Conclusions Patients with recurrent HCC, HBV-related HCC, cirrhosis, and the absence of antiviral therapy showed significantly lower overall survival rates. Furthermore, LC3 expression in both the tumor and liver microenvironments were significantly predictive of overall survival after resection for HCC.

Original languageEnglish
Article numbere0202650
JournalPLoS ONE
Volume13
Issue number9
DOIs
StatePublished - 09 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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